Coaching Questionnaire

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Personal Information

Name

First Name

Last Name

Age

Birth Date

Mailing Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Best Phone Number to Reach You At

Best Email to Reach You At

What is the name of your Significant Other? How long have you been together?

What are the name(s) of your Children / Ages? (If Any)

What are some of your “Other interests” outside of work?

Coaching Questionnaire

Why are you looking forward to Strategic Coaching at this time?

What are you truly looking for in this relationship?

What are your Top 3 Short Term Goals? (Short Term meaning one year or less). Please be as specific as possible in answering this question.

What are your Top 3 Long Term Goals? (Long Term meaning MORE than one year). Please be as specific as possible in answering this question.

What is your Ultimate Vision you want for your life?

Who are some of your Role Models or who has been extremely influential in your life so far? (List as many as you like)

There is something we'll be talking about called the 6 Human Needs. I'm curious to know, when you read through this list, which two do you believe are driving you the MOST at this time of your life? What do you need more of?

What is your greatest strength right now?

Where are you most reliable, disciplined and focused?

What is a weakness, an obstacle or a limiting belief that you'd like to deal with right now?

What do you think about the most during your day and what is your most dominant thought?

What do you find yourself sharing with others or what do you talk about that lights you up?

What inspires you the most?

What do you want your life to look like 6 months from now, and how will you measure it?

Is there anything else you'd like to say or that you would like me to know, before we start working together?

Coaching Questionnaire

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